Lyme borreliosis reinfection: might it be explained by a gender difference in immune response?
Lyme borreliosis reinfection: might it be explained by a gender difference in immune response?
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DOI：
10.1111/j.1365-2567.2006.02360.x
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发表时间：
2006-06-01
期刊：
影响因子：
6.4
通讯作者：
Ernerudh, Jan
中科院分区：
文献类型：
--
作者：
Jarefors, Sara;Bennet, Louise;Ernerudh, Jan
莱姆疏螺旋体病是一种扁虱传播的疾病，通常表现为环状皮肤病变。这种皮肤形式的疾病被称为迁延性红斑。在瑞典南部的一项为期5年的跟踪研究中，708名最初被诊断为迁徙红斑并接受抗生素治疗的患者中，有31人被发现再次感染伯氏疏螺旋体。尽管男性和女性被扁虱叮咬的程度相同，但在31名再次感染的患者中，有27名是女性，她们都超过了44岁。这项研究的目的是确定这种性别分布的差异是否可能是免疫反应差异的结果。20名单一感染者和21名再次感染者女性以及18名单一感染者和3名再次感染者男性参与了这项研究。没有一名参与者表现出任何持续感染伯氏杆菌的迹象，因此捕捉到了习惯性反应。从血液中分离淋巴细胞，用抗原刺激。采用酶联免疫吸附试验(EL ISA)、酶联免疫吸附斑点形成细胞试验(ELISPOT)或免疫印迹法(IMMULITE)检测IL-4、IL-6、IL-10、干扰素(IFN)-γ和肿瘤坏死因子(TNF)-α的分泌。一次感染和二次感染患者的细胞因子分泌无明显差异。我们还比较了男性和女性的免疫反应，而不考虑伯氏杆菌感染的数量。女性表现出明显更高的自发分泌所有细胞因子的测量。女性IL-4/干扰素-γ和IL-10/肿瘤坏死因子-α比值明显高于女性。免疫反应的性别差异可能在一定程度上解释了女性再感染率较高的原因。在女性中看到的较高的IL-4：干扰素-γ和IL-10：肿瘤坏死因子-α的比率表明，绝经后的女性具有辅助性T细胞2型(Th2)导向的反应性，炎症反应受损，这可能会抑制螺旋体的消除。
Lyme borreliosis is a tick-borne disease often manifesting as a circular skin lesion. This cutaneous form of the disease is known as erythema migrans. In a 5-year follow-up study in southern Sweden, 31 of 708 individuals initially diagnosed with erythema migrans and treated with antibiotics were found to be reinfected with Borrelia burgdorferi. Although men and women were tick-bitten to the same extent, 27 of the 31 reinfected individuals were women, all of whom were over 44 years of age. The aim of this study was to determine whether this discrepancy in gender distribution could be a result of differences in immunological response. Twenty single-infected and 21 reinfected women and 18 single-infected and three reinfected men were included in the study. None of the participants showed any sign of an ongoing B. burgdorferi infection, and thus the habitual response was captured. Lymphocytes were separated from blood and stimulated with antigens. The secretion of interleukin (IL)-4, IL-6, IL-10, interferon (IFN)-gamma and tumour necrosis factor (TNF)-alpha was measured by enzyme-linked immunosorbent assay (ELISA), enzyme-linked immunosorbent spot-forming cell assay (ELISPOT) or Immulite. No difference was detected in cytokine secretion between single-infected and reinfected individuals. We also compared the immunological response in men and women, regardless of the number of B. burgdorferi infections. Women displayed a significantly higher spontaneous secretion of all cytokines measured. The ratios of IL-4:IFN-gamma and IL-10:TNF-alpha were significantly higher in women. Gender differences in immune reactivity might in part explain the higher incidence of reinfection in women. The higher IL-4:IFN-gamma and IL-10:TNF-alpha ratios seen in women indicate that postmenopausal women have T helper type 2 (Th2)-directed reactivity with impaired inflammatory responses which might inhibit the elimination of spirochetes.